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Piatkova Y, Doyen M, Heyer S, Tahmazov A, Frismand S, Hopes L, Imbert L, Verger A. Effects of medication on dopamine transporter imaging using [ 123I]I-FP-CIT SPECT in routine practice. Eur J Nucl Med Mol Imaging 2024; 51:1323-1332. [PMID: 38114618 DOI: 10.1007/s00259-023-06565-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE Dopamine transporter (DAT) imaging is used to support the diagnosis of neurodegenerative parkinsonian disorders. Specific medications have been reported to confound the interpretation of [123I]I-FP-CIT SPECT scans, but there is limited data. The aim of the current study is to identify potential medication effects on the interpretation of [123I]I-FP-CIT SPECT scans in routine practice. MATERIALS AND METHODS Consecutive patients undergoing a [123I]I-FP-CIT SPECT/CT scan on a 360° CZT camera between September 2019 and December 2022 were included. An exhaustive review of patient medications (antidepressants, antipsychotics, anti-epileptics, anti-parkinsonians, benzodiazepines, lithium, opioids, and stimulants) was performed. Two experienced nuclear physicians, blinded to the medication reports, interpreted the [123I]I-FP-CIT SPECT scans visually and a semi-quantitative analysis was performed using a local normal database. RESULTS The study included 305 patients (71.0 ± 10.4, 135 women) and 145 (47.5%) visually interpreted normal scans. In normal scans, the striatum/occiput radioligand uptake ratio was decreased by noradrenergic and specific serotonergic antidepressants (NASSAs) (n = 15, z-score of - 0.93) and opioid medication (tramadol, n = 6, z-score of - 0.85) and was associated with a younger age in the multivariate analysis. In the overall population, the striatum/occiput ratio was influenced by NASSAs and associated with consensual visual analysis, age, sex, and anti-parkinsonian medications related to the status of the disease. CONCLUSION Our study confirms the potential impact of antidepressant (NASSA) and opioid (tramadol) medications on the semi-quantitative analysis of [123I]I-FP-CIT SPECT scans. However, when performing a visual analysis, only NASSAs significantly impacted the interpretation of [123I]I-FP-CIT SPECT scans.
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Affiliation(s)
- Yuliya Piatkova
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, F-54000, Nancy, France
| | - Matthieu Doyen
- IADI, INSERM U1254, Université de Lorraine, F-54000, Nancy, France
| | - Sébastien Heyer
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, F-54000, Nancy, France
| | - Ayaz Tahmazov
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, F-54000, Nancy, France
| | - Solene Frismand
- Department of Neurology, Université de Lorraine, CHRU de Nancy, F-54000, Nancy, France
| | - Lucie Hopes
- Department of Neurology, Université de Lorraine, CHRU de Nancy, F-54000, Nancy, France
| | - Laetitia Imbert
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, F-54000, Nancy, France
- IADI, INSERM U1254, Université de Lorraine, F-54000, Nancy, France
| | - Antoine Verger
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, F-54000, Nancy, France.
- IADI, INSERM U1254, Université de Lorraine, F-54000, Nancy, France.
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Rogner D, Heimerl L, Heyer S, Biedermann T, Sattler E, Zink A. Patients' perspective, quality of life and treatment goals in Hailey-Hailey disease: Lessons learned from the German National Registry. J Eur Acad Dermatol Venereol 2024; 38:419-429. [PMID: 37863661 DOI: 10.1111/jdv.19583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/06/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Hailey-Hailey disease (HHD) remains a difficult-to-treat dermatosis and little is known about the patient's perception of the disease activity, the treatment success and its impact on quality-of-life (QoL). OBJECTIVE To obtain better understanding of HHD patients' needs regarding their medical condition, financial burden, QoL, subjective well-being and treatment thereof as well as satisfaction to evaluate common treatments' 'real-life' relevance. METHODS With initiation of the national registry for Darier's disease (DD; Morbus Darier, MD) and Hailey-Hailey disease (HH) MDHHgermany, patients with HHD diagnosis were included starting June 2020. To assess subjective symptoms, patients filled out questionnaires such as the DLQI (dermatological life quality index), numeric rating scale (NRS) for itch, pain and burning sensation, as well as the SWLS (satisfaction with life scale) questionnaire to quantify overall satisfaction in life. Additionally, data on therapies were collected along with the patients' satisfaction of those and their medical care. Furthermore, patients assessed financial aspects and work ability. RESULTS One hundred and two patients were recruited from dermatology clinics, office-based dermatologists and self-help platforms across Germany between June 2020 and February 2023, 90 were eligible and analysed (mean: 49.91 years, 73.33% females, 26.67% males). 39.77% stated according to the DLQI their life is severely/very severely affected. Satisfaction with life was mediocre. Burning sensation was most pronounced among subjective symptoms (NRS 5.85 ± 2.80). Systemic treatments were rated as ineffective according to 56.92%, 25.56% had never received one. Most prescribed systemic treatments were corticosteroids (73.8%), followed by low-dose naltrexone (LDN) (26.2%), retinoids (15.4%) and antibiotics (13.8%). Satisfaction with medical care was generally low. CONCLUSION Our 'real-life' data state a major disease burden and impact on the QoL for affected individuals, as well as limited disease control due to inadequate therapies. MDHHgermany can provide insights into improvement of healthcare support with this debilitating disease and improve QoL. In the long term, it aims to provide basis for further clinical trials, epidemiological studies and immunological investigations.
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Affiliation(s)
- D Rogner
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - L Heimerl
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Pharmacology and Toxicology, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - S Heyer
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - E Sattler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Doyen M, Hossu G, Heyer S, Zaragori T, Imbert L, Verger A. Identification of resting-state networks using dynamic brain perfusion SPECT imaging: A fSPECT case report. Front Hum Neurosci 2023; 17:1125765. [PMID: 37151905 PMCID: PMC10157397 DOI: 10.3389/fnhum.2023.1125765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/21/2023] [Indexed: 05/09/2023] Open
Abstract
Connectivity studies with nuclear medicine systems are scarce in literature. They mainly employ PET imaging and group level analyses due to the low temporal resolution of PET and especially SPECT imaging. Our current study analyses connectivity at an individual level using dynamic SPECT imaging, which has been enabled by the improved temporal resolution performances provided by the 360°CZT cameras. We present the case of an 80-year-old man referred for brain perfusion SPECT imaging for cognitive disorders for whom a dynamic SPECT acquisition was performed utilizing a 360°CZT camera (temporal sampling of 15 frames × 3 s, 10 frames × 15 s, 14 frames × 30 s), followed by a conventional static acquisition of 15 m. Functional SPECT connectivity (fSPECT) was assessed through a seed correlation analysis and 5 well-known resting-state networks were identified: the executive, the default mode, the sensory motor, the salience, and the visual networks. This case report supports the feasibility of fSPECT imaging to identify well known resting-state networks, thanks to the novel properties of a 360°CZT camera, and opens the way to the development of more dedicated functional connectivity studies using brain perfusion SPECT imaging.
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Affiliation(s)
- Matthieu Doyen
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, Université de Lorraine, Nancy, France
- IADI, INSERM U1254, Université de Lorraine, Nancy, France
- *Correspondence: Matthieu Doyen,
| | - Gabriela Hossu
- IADI, INSERM U1254, Université de Lorraine, Nancy, France
- CHRU-Nancy, INSERM, CIC, Innovation Technologique, Université de Lorraine, Nancy, France
| | - Sébastien Heyer
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, Université de Lorraine, Nancy, France
| | | | - Laetitia Imbert
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, Université de Lorraine, Nancy, France
- IADI, INSERM U1254, Université de Lorraine, Nancy, France
| | - Antoine Verger
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, Université de Lorraine, Nancy, France
- IADI, INSERM U1254, Université de Lorraine, Nancy, France
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Doyen M, Chawki MB, Heyer S, Guedj E, Roch V, Marie PY, Tyvaert L, Maillard L, Verger A. Metabolic connectivity is associated with seizure outcome in surgically treated temporal lobe epilepsies: A 18F-FDG PET seed correlation analysis. Neuroimage Clin 2022; 36:103210. [PMID: 36208546 PMCID: PMC9668618 DOI: 10.1016/j.nicl.2022.103210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/14/2022] [Accepted: 09/22/2022] [Indexed: 12/14/2022]
Abstract
18F-FDG PET provides high sensitivity for the pre-surgical assessment of drug-resistant temporal lobe epilepsy (TLE). However, little is known about the metabolic connectivity of epileptogenic networks involved. This study therefore aimed to evaluate the association between metabolic connectivity and seizure outcome in surgically treated TLE. METHODS The study included 107 right-handed patients that had undergone a presurgical interictal 18F-FDG PET assessment followed by an anterior temporal lobectomy and were classified according to seizure outcome 2 years after surgery. Metabolic connectivity was evaluated by seed correlation analysis in left and right epilepsy patients with a Class Engel IA or > IA outcome and compared to age-, sex- and handedness-matched healthy controls. RESULTS Increased metabolic connectivity was observed in the >IA compared to the IA group within the operated temporal lobe (respective clusters of 7.5 vs 3.3 cm3 and 2.6 cm3 vs 2.2 cm3 in left and right TLE), and to a lower extent with the contralateral temporal lobe (1.2 vs 0.7 cm3 and 1.7 cm3 vs 0.7 cm3 in left and right TLE). Seed correlations provided added value for the estimated individual performance of seizure outcome over the group comparisons in left TLE (AUC of 0.74 vs 0.67). CONCLUSION Metabolic connectivity is associated with outcome in surgically treated TLE with a strengthened epileptogenic connectome in patients with non-free-seizure outcomes. The added value of seed correlation analysis in left TLE underlines the importance of evaluating metabolic connectivity in network related diseases.
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Affiliation(s)
- Matthieu Doyen
- Université de Lorraine, Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, F-54000 Nancy, France,Université de Lorraine, IADI, INSERM U1254, F-54000 Nancy, France,Corresponding author at: Université de Lorraine, IADI - INSERM U1254, Department of Nuclear Medicine and Nancyclotep Imaging Platform, F-54000 Nancy, France.
| | - Mohammad B. Chawki
- Université de Lorraine, Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, F-54000 Nancy, France
| | - Sébastien Heyer
- Université de Lorraine, Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, F-54000 Nancy, France
| | - Eric Guedj
- Aix Marseille Univ, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, Nuclear Medicine Department, F-13000 Marseille, France
| | - Véronique Roch
- Université de Lorraine, Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, F-54000 Nancy, France
| | - Pierre-Yves Marie
- Université de Lorraine, Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, F-54000 Nancy, France,Université de Lorraine, INSERM, DCAC, Nancy, France
| | - Louise Tyvaert
- Université de Lorraine, CRAN UMR 7039, Nancy, France,Department of Neurology, CHRU Nancy, National Reference Center for Rare Epilepsies, F-54000 Nancy, France
| | - Louis Maillard
- Université de Lorraine, CRAN UMR 7039, Nancy, France,Department of Neurology, CHRU Nancy, National Reference Center for Rare Epilepsies, F-54000 Nancy, France
| | - Antoine Verger
- Université de Lorraine, Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, F-54000 Nancy, France,Université de Lorraine, IADI, INSERM U1254, F-54000 Nancy, France
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Abstract
Intestinal permeability to a monosaccharide and a disaccharide was compared by simultaneous measurement of the urinary excretion of L-rhamnose and lactulose after oral ingestion of an hypertonic solution containing both sugars. Urine samples were analysed for sugar content by quantitative thin-layer or paper chromatography. Results in thirteen patients with untreated villous atrophy were compared with those in twelve healthy volunteers. Urinary L-rhamnose excretion was significantly decreased (-40%, p less than 0.02) in patients with villous atrophy, whereas lactulose excretion was paradoxically and significantly increased (+345%, p less than 0.01). The median value of the lactulose/L-rhamnose urinary excretion ratio was sevenfold higher in the patients with villous atrophy; there was no overlap of values for patients and volunteers (p less than 0.01). It is postulated that reduced L-rhamnose urinary excretion in untreated villous atrophy is due to a decreased absorptive area in the small bowel, whereas increased lactulose excretion indicates leakiness of the abnormal mucosa to larger polar molecules.
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